Peripheral Vascular Injury Management

Introduction

  • Peripheral vascular injury can be life-threatening or limb-threatening.  Proper understanding of pathology and management is important in the ER.
  • Vascular injuries can be internal and may not be obvious on presentation. Patients with blunt or penetrating trauma who remain hypotensive after a fluid bolus challenge may have internal hemorrhage.
  • Incidence of penetrating and blunt trauma in the US has been rising.
  • Blunt and penetrating causes of peripheral vascular injuries are about equal in the US.
  • Low velocity gunshot wounds are the second leading cause of death in the 15- to 34-year-old age group in the US.  Peripheral vascular injury has been reported to be present in up to 50% of these cases.

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